September 8, 2021 • 24 mins
How you can help people in your community gain access to reproductive healthcare and flip off the Texas legislature.
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Speaker 1 (00:03):
Hey, everybody, this is Robert Evans and welcome once again too.
It could happen here a podcast where we're talking about
the fact that, you know, things are kind of falling apart,
and we try to arm you with information to help
deal with that. Um As I'm sure most of you
are aware, one of the big news pieces that happened
just about two days ago when as I'm recording this,
(00:25):
is that the state of Texas finally rammed through a
massive abortion restriction that essentially kind of their their goal
and they've so far been successful. Inness was kind of
looping around Roe v. Wade by essentially deputizing regular Texans
to uh get ten dollar bounties on their their fellow
(00:46):
citizens by reporting people who get abortions after six weeks um,
in addition to kind of shutting down an illegal avenue
to do that. So the Supreme Court has so far
punted on taking any action on that, and it's it's
a pretty desperate situation. There's now rumblings that Florida is
going to try to do the same thing, and as
a result, there's never been a more um important time
(01:11):
to talk about the subject of today's episode, which is
self managed abortion UM. And in order to talk about that,
because I'm certainly no expert, we've got Susan Yano, who
was a co founder of Women Help Women UH and
Self Managed Abortion Safe and Supported UM. Susan, thank you
very much for coming on the show and talking with
me today. Sure, it's nice to be here. And UM.
(01:34):
Maybe a place to start is to talk about what
self managed abortion is. Yeah, because one of the things
that is shocking, even though abortion pills have been allowed
by the FDA in this country since two thousand, lots
of people don't know that there are pills that essentially
cause a miscarriage. They have been available in clinics since
(01:55):
the year two thousand, but even more importantly, they've been
available out side the clinics since the nineteen eighties, and
people in other countries have been using them on their
own safely and effectively, and increasingly over the last decade,
people in this country have been using these exact same
pills UM safely and effectively on their own. So I
(02:19):
just want to be clear because people when they hear
the words self managed abortion might flash on unsafe methods
like sharp objects or herbs, which can be safe but
can be unsafe but haven't really been scientifically documented. These
pills have been studied more than almost any other medicine
(02:40):
on the planet. And so we know from science that
misaprostal with or without methoprista, that's the names of the
pills UM causing a safe abortion. And you know, I
was listening to an interview with you earlier today and
you brought up something that I was unaware of, which
is that these medicines kind of got their start being
(03:00):
used for self managed abortion in Latin America, where abortion
is legal, abortion at least is in many places just
not available. UM and women it was this it was
initially an ulcer drug. Am I remembering that correct. Misa
Prostel was originally registered for ulcers. And it was women
in Brazil who noticed that right on the pill container
(03:21):
it said do not use if you're pregnant, could cause
undine contractions. And as in every country in the world
for generations, if people don't want to be pregnant, they
try to figure out a way to add that pregnancy,
regardless of the law. So women started experimenting with taking
misa prostal. Ultimately, the World Health Organization has studied these
(03:42):
pills and come up with the most recommended protocols, which
people can find on our website abortion pill info dot
org or in many many places in the Internet if
they google the words and Lisa Prostal and abortion and
you're you're going to sation doesn't provide the pills, but
you do provide people information on how right the idea
(04:05):
of sunds because there are restriction there are some legal
risks in people in these pills on there on, even
before this draccone in law in Texas which tries to
criminalize everybody, um, but it is legal to share information
that's published in scientific journals and by the world's health organization.
So on the website abortion pill infot dot org are
(04:26):
the protocols for how to use mice acrosto alone or
in combination with metho christo, because it is a little
more effective with when combined with methochristo, but the metho
cristo is harder to get to get. And I you know,
people I think are often frightened about just the idea
of self managed abortion, in part because when people talk
(04:46):
about the bad old days before Roe v. Wade, they're
talking about something that I think people would think about
when they hear self managed abortion, if they're not aware
of kind of what it actually is. But one of
the points you make that I think is so valid
is that just a in its own like if you
do nothing about pregnancies self terminate on their own, and
(05:07):
this is what the pills are doing. It's nothing different
than what happens if you just kind of have an
embryo stop. Exactly. The pills caused the unse to contract
and push out whatever is in there. Um. I think
it's I think you raise a really important issue because
there's two things. One is these abortion pills have been
so tightly regulated and controlled by our medical um institutions
(05:31):
that people aren't as familiar with them as they could
and should be. I mean, these pills are so safe
that they could be in people's medicine cabinets. Um. But
in this country, sexuality is really restricted. We should have
over the counter birth control pills that biled. So the
first thing is I think is just to demystify these
pills and to say that they're safe and effective. But
the other is the stigma around abortion. Yeah, the anti
(05:54):
abortion people have worked really hard to make people ashamed
about their sexuality and ashamed about a pregnancy that they
didn't want, as if people can do it all by
themselves without somebody else being involved. And so this burden
on women is they don't even they're so shamed that
they have a lot of fear and stigma around, um,
trying to get an abortion, even outside of Texas. But
(06:17):
then you compound it with this fear that has been
raised by the anti abortion people, all this misinformation, Oh
these pills aren't saying, oh they could cause breast cancer,
Oh they can impair future fertility, all of which has
been debunked and is not true. But as we all know,
misinformation has a long shelf life, a longer shelf life
(06:38):
than the truth in a lot of cases. Exactly, I
wanna talk a little bit about just kind of the
facts about how this stuff functions. So particularly from IM
we have a lot of listeners in Texas. I'm sure
a decent number of the people listening right now are
are very rightfully concerned. The present law essentially criminalizes uh
(07:01):
medical abortion after six weeks um at what's how how
late through do these pills work? Um? And then the
second question I have is obviously a lot of women
who get pregnant, don't realize they're pregnant for until after
six weeks. It can take a while. So what options.
I know you have some options to recommend for tracking
uh that that that that are helpful as well an app.
(07:24):
So the first thing I just want to say is UM,
a lot of people don't know how to calculate the
number of days of pregnancy, and they hear this term
l MP last menstrual period. Basically, people can count from
the first day of their last menstruation to figure out
how pregnant they are. UM. We do have an app
that I want to recommend called Yuki e u k
I comes from the word eucalyptus, which is a menstrual tracker,
(07:48):
but also has information about how to use contraception, how
to use abortion pills. It is private and secure. UH.
The the information is not available to anybody. It was
not commercially developed, was developed by grants. So even we
don't know other than how many people download it, we
don't know how people are using it. So I really
I think it's really important that people understand how their
(08:10):
bodies work, understand how to figure out how pregnant they are,
and then understand how to use these pills. You asked
a really important question, which is how late can these
pills be used? Um, The w h O has studied
the use of these pills through twelve weeks, and there
is a set of protocols for how to use them
for twelve weeks and basically, with mice across alone, a
(08:31):
person would need twelve tablets two hundred micrograms each. They
would put four pills under their tongue, let them dissolve
thirty minutes and then swallow, wait three hours to do
it again, four pills under the tongue thirty minutes and
then wait three hours and then use the last four pills. However,
after twelve weeks, the pills can also be used to
(08:53):
end up pregnancy. Mice acrostal can be used for labor induction.
Counter Intuitively, however, the large longer the pregnancy, the less
mice across them is needed, and a person doesn't want
to take too much. Exactly, you and I probably think, oh,
I have a headache, I'll take to ask for it.
Oh it didn't go away, I'll take two. More counter intuitively,
as the uterus stretches with pregnancy, it's more sensitive to
(09:15):
mines approsto and actually can be dangerous to use as
much as one would use in the first twelve weeks.
Anybody who wants to learn more can either go on
the website abortion pill info dot org or use that
website and contact skilled counselors from Women Help Women who
are based overseas, who answer over twelve thousand emails a
(09:36):
month about how to use these pills, and they will
counsel people regardless of the number they need to know,
how many weeks pregnancies they will they will adapt the
information to that situation. But most people in this country
who have gone to clinics for abortion do it in
the first nine or ten weeks, and these pills are
extremely safe and effective to use with these w H
(09:58):
protocols up to twelve weeks. So while you're correct that
most people don't know they're pregnant at six weeks, they
at the time they're they've missed a period usually and
they're they've taken a pregnancy test, and the urin pregnancy
test that people buy in the dollar store over the
pharmacy are pretty are pretty accurate. Yeah, you brought up something,
(10:29):
which is that who have these people who can help
provide advice and their overseas, and you you kind of
specify that every time I see you, I hear you
talk about it, and you also specify the degree of
security um which you which you put on these conversations UM.
And it's a degree that I think is uncommon for
(10:50):
what should be a pretty basic medical procedure. And it's
obviously because of there's potential consequences here. I'm interested in
kind of what are some of the present legal consequence
is and what are some of your worries when you
adopt these very stringent security measures for people who come
to you. So let's leave Texas aside. Prior to the
Texas law, approximately twenty four people in the United States
(11:13):
have been prosecuted for using abortion pills without a clinician involved,
in other words, for self managing their abortion UM. It's
important to say most of the people who were prosecuted
were not ultimately convicted, but somewhere because many states criminalize
the use of these pills without a clinician involved. That
(11:34):
being said, thousands and thousands of thousands of people are
obtaining mys acostal or mio cristal plus myz acrostal in
the United States. We have some websites where that actually
share the number of pills that they're sending into the US.
And we also know about my acrostal sales um going
way up in the countries where it is available of
(11:56):
an encounter, so there's no doubt. And also people have
shared their stories, so there that twenty four is a
tiny percentage of all the people who have been who
have used these pills. However, these pills are safe and
effective and nobody should have legal risk in using them. Therefore,
when we set up SASS, which is self managed abortion,
(12:16):
safe and supported and it's a project of this international
organization Women Help Women, we were very aware that in
the U s there's a lot of surveillance of people's bodies,
there's a lot of potential to pack into people's emails.
So we set up a very secure system where people
can email our overseas counselors UM on a very secure
(12:38):
server and get back a an answer that will disappear
within seven days, so there's no evidence in their phone
or electronic device that they ever sent this email. We
just thought, you know, it's an extra step. Um. Most
people probably aren't even aware they're going through a secure site,
but we want to make sure that nobody who who
contacts us can ever be prosecuted. Yeah, and it's I mean,
(13:02):
it seems like you're were especially given the nature of
the Texas law, you're worried about vigilantes as much as anything,
not necessarily even the state, but but you know, the
kind of people who show up outside of planned parenthoods
with guns. The good thing about an international organization running
this is none of the people answering the email are
in the US. Yeah, pretty difficult for these Texas vigilantes
(13:22):
or frankly anybody else to file a lawsuit. First of all,
it's all anonymized. They don't we don't. Women Help Them
doesn't advertise who our staff are, and none, none of
them are in this country. I mean, that's very smart.
When did when was it set up this way? Like
how long ago were you kind of thinking about the direction,
because it seems like you you had a pretty blunt
(13:45):
understanding of where things were headed. So Women Help Women
was founded in and we work in eighty two countries.
We work in countries like the Philippines where any kind
of drug deal dealer has been called. Yeah, work in
Poland where abortion is not legal. In anywhere in the country.
We work in many places in Latin America where abortion
(14:08):
is highly criminalized, so we had security set up from
the beginning. It was actually shortly after the election of
h I'll call him Orange forty five because I've sworn
that this our ex president's name, will never cross my lips.
Uh from Poland said, you know, we used to have
legal abortion and we lost it, and you're gonna lose
it too. People in the US better, you know, we
(14:31):
should do something for people in the United States, and
that's why so SAS was founded shortly after the inauguration
of the last president and has been in place ever since.
A lot of our work is not just the website
and answering, it's really raising the awareness of our colleagues.
We also before COVID went into communities. Now we do
(14:51):
it for via Zoo. We actually do three hour trainings
to teach people how to use these medicines and how
to teach others' we uh, you know, we have manual Spanish.
We have people doing these trainings all over the US
UM and have reached thousands of people directly with this
information UM sort of prophylactically with the belief that it
(15:14):
shouldn't be when a person is pregnant that they understand
how these pills work. This is basic information that gotten
in high school. It's like knowing how to put on
a tourniquet or something. It should be part of your
first stage. How do you when to put on a
band aid and when to take an aspirint? You know,
how do you treat a cold? So the knowledge about
(15:35):
these pills, we've worked very hard to make it very accessible.
We actually have load we you know, we've done these
trainings and countries where there's not a lot of literacy,
so with graphics, we have videos. We have lots of
ways to teach. Many aren't appropriate for the u S
where there's more literacy but sometimes less understanding about how
bodies work. So um. So our goal has been to
(15:57):
you know, we also go to professional conferences and so
channels and try to raise awareness within the reproductive rights
and reproductive justice movement about the importance of self managed
abortion as an intol of empowerment and breaking stigma. Not
as hey, if you can't get to a clinic, tribes,
but why why is this option not available to me?
In a state of Massachusetts where I live where there's
(16:19):
plenty of clinics, But why can't I just walk down
to the to the Walgreens and get these pills if
a doctor tells me it's okay, or without a doctor, Yeah,
they're so safe. So we've really, we really advocate for
self managed abortion as a viable option. UM. It should
be viable regardless of the law. Obviously for many people
it's the only option in places like Texas. UM. But
(16:44):
it's as good, it's a better. Some people don't want
to go see a clinician. Yeah, they don't want to
go through a bunch of protesters. They would just like
to get a package in the mail with their medicines. Yeah,
I mean it's and that's I mean, there's there's both
the the tool of an immediate need that there's there's
desperate people who need access to this, but it's also
in a broader sense, like building power within individuals and
(17:07):
within communities to manage their own reproductive healthcare, which I
think is really important exactly. And there are people who
could get to a clinic and have them needs to
go to a clinic, who are opting not to go
to a clinic. And two because they feel confident in
their ability to take these pills as directed to manage it.
And I just want to say, we started this conversation
(17:27):
with talking about of all praises end in a miscarriage.
Most people have a miscarriage don't get medical care. Yeah,
they can manage the bleeding and they know when it's
over and they know that fine, which I think is
an important point because I know people who have had
very difficult miscarriages, but that's not most of the most
of them are are mild enough that yeah, like you said,
(17:49):
you don't need medical care. Well, I just so, I
just want to be clear. You know, using the abortion
pills does cause cramping and bleeding, but it is not
so far out of most people with the uterus is
experience to have cramping and bleeding every month. This is
heavier cramping, heavier bleeding, but we we know how to
(18:10):
deal with this. Another point you make that I think
is really important is that you know, with any medication,
there's a chance it will be used wrong or it'll
have an expected effect. If you have to if you
(18:31):
take this stuff and you have to go to the doctor,
you don't need to tell the doctor. This is what
I've taken you you like, could you talk to that
about a little bit how someone would if they needed
to go to the doctor as a result of an
interaction or something, what they would would be best to say.
There are two kinds of complications that can happen in
very very rare cases. The person can bleed too much,
(18:51):
have a hemorrhage, and they absolutely mean medical care. The
chance of a hemorrhage with these pills is exactly the
same as the has a chance of the hemorrhage with
a natural miscare. So it happens. Doctors in every e
r know how to treat it. The other complication that
can happen is in infection. You know, there's some retained
tissue and the bleeding continues and they need to get antibiotics.
(19:13):
So what's really interesting about these pills is they move
through the body relatively quickly and there is no test
of blood or urine for them as long as the person,
especially if the person followed the directions and use them
under the tongue or in the cheeks, they've gone through
the stomach, they're gone. Yeah. In some directions say to
use the MISA prostal vaginally. The problem with that is
(19:37):
the inert substances, and the pills could stay in the
vagina for up to three days, and then there's evidence,
right because the doctor could see the crumbs if they
do a pelvic exam. But as long as the person
used the pills, either used the mice aprostal one swallows
the mephopristom, as long as they use it in the
and that's absorbed through the mouth, there are no tests.
So the person can say I'm bleeding and I don't
(19:59):
know why, which, by the way, many people with a
miscaracter now they were pregnant. Happens all the time, or
they could say I was pregnant and I think I'm
having a miscarriage. Yeah, we are really trying to work
with some professional groups to increase awareness that people shouldn't
be vigilanties, healthcare providers should not be vigilanties. But the
(20:20):
only way a person is going to get in trouble
is if they say they use the medicines. Even if
the doctor says, did you use the medicines, there is
no reason to say it. The treatment is exactly the
same as for a natural miscarriage. I wanted to ask
kind of how listeners, particularly listeners who you know may
not personally need this medicine but may want to support
(20:44):
what you're doing, or may need the medicine and still
want to support what you're doing. Are there ways in
which people can either financially or otherwise help support y'all?
Absolutely again. Abortion pill info dot Org is our website.
There's a whole section of what people can do. They
can they can learn about these pills and tell other people.
They can get stickers to let people know they exist.
Because remember, most people don't know there are abortion pills,
(21:06):
so they don't even know how to look on the
internet for this thing, you know, so sharing information is
really important. There's also a donation button there, but the
biggest thing that people can do in this moment, apart
from donating, is to educate themselves. They can either sign
up to take one of our trainings and become a
(21:27):
We call them trainers, but it's really information sharing. You know,
you and I have just talked about these pills. You
understand them more than you did half an hour ago.
Training a little too formal of a term for what
we do, but afterwards people will understand these pills very
well and be able to support others who either want
to know about them or are using them. And the
(21:47):
last thing I'd kind of like to ask you, if
you don't mind sharing, is how did you get into
this personally? Like what brought you into this line of
good question. So I've been doing abortion access work since
the eighties. UM. I was involved in the big demonstrations
in front of the clinics, etcetera. But I've also spent
(22:08):
a lot of time in Mexico where these pills are
over the counter and no, And it wasn't until and
I'm a little embarrassed to say this, but it wasn't
until about fifteen years ago that it's suddenly occurred to me,
Wait a second, I wonder why people in the US
aren't doing what what people in Mexico are doing. I'm just,
you know, it just it's like I was crossing the border,
(22:28):
but the idea hadn't crossed. And I started working with
another international organization of Women on Waves that was supplying
these pills all over the world, and I learned more
about them, and I eventually gave up my other day
job UM and started doing this work more directly over
the last ten years. Awesome, UM, Well, Susan, I think
(22:52):
that's everything I had to ask. Was there anything else
you wanted to make sure to get out today? No,
I just want to be really clear that well, this
is a human right and that they're people should have
the option of going to a clinic. And the closing
of the what you know, this is going to result
in clinics in Texas being down essentially nobody who's you know,
and they can't keep their doors open with a few
(23:14):
people who happen to get in before six weeks. And
I think we have to do everything possible to support
there being access to clinicians, that this is an option
that we all need to learn more about and to
think about why why is this so controlled? If this
was a medicine, like it's more controlled than than opiates.
It's certainly more controlled than beyond and it's crazy and
(23:39):
it's a misogynistic that these pills are not in our hands. So,
um yeah, I would encourage your listeners to get on
the website if they want more information there is you know,
they can easily email through the website and learn whatever
they want. Um. But it's all of our responsibility to
learn this and to help get this information out absolutely,
(24:02):
Susan Yano, thank you so much for talking with us
today and thank you all for listening. This has been
It Could Happen Here and we'll be back tomorrow UM
with another episode. Thank you so much, season you're very well.
It Could Happen Here as a production of cool Zone Media.
(24:23):
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cool zone Media dot com, or check us out on
the I Heart Radio app, Apple Podcasts, or wherever you
listen to podcasts. You can find sources for It Could
Happen Here, updated monthly at cool zone Media dot com
slash sources. Thanks for listening.
Hey, everybody, this is Robert Evans and welcome once again too.
It could happen here a podcast where we're talking about
the fact that, you know, things are kind of falling apart,
and we try to arm you with information to help
deal with that. Um As I'm sure most of you
are aware, one of the big news pieces that happened
just about two days ago when as I'm recording this,
(00:25):
is that the state of Texas finally rammed through a
massive abortion restriction that essentially kind of their their goal
and they've so far been successful. Inness was kind of
looping around Roe v. Wade by essentially deputizing regular Texans
to uh get ten dollar bounties on their their fellow
(00:46):
citizens by reporting people who get abortions after six weeks um,
in addition to kind of shutting down an illegal avenue
to do that. So the Supreme Court has so far
punted on taking any action on that, and it's it's
a pretty desperate situation. There's now rumblings that Florida is
going to try to do the same thing, and as
a result, there's never been a more um important time
(01:11):
to talk about the subject of today's episode, which is
self managed abortion UM. And in order to talk about that,
because I'm certainly no expert, we've got Susan Yano, who
was a co founder of Women Help Women UH and
Self Managed Abortion Safe and Supported UM. Susan, thank you
very much for coming on the show and talking with
me today. Sure, it's nice to be here. And UM.
(01:34):
Maybe a place to start is to talk about what
self managed abortion is. Yeah, because one of the things
that is shocking, even though abortion pills have been allowed
by the FDA in this country since two thousand, lots
of people don't know that there are pills that essentially
cause a miscarriage. They have been available in clinics since
(01:55):
the year two thousand, but even more importantly, they've been
available out side the clinics since the nineteen eighties, and
people in other countries have been using them on their
own safely and effectively, and increasingly over the last decade,
people in this country have been using these exact same
pills UM safely and effectively on their own. So I
(02:19):
just want to be clear because people when they hear
the words self managed abortion might flash on unsafe methods
like sharp objects or herbs, which can be safe but
can be unsafe but haven't really been scientifically documented. These
pills have been studied more than almost any other medicine
(02:40):
on the planet. And so we know from science that
misaprostal with or without methoprista, that's the names of the
pills UM causing a safe abortion. And you know, I
was listening to an interview with you earlier today and
you brought up something that I was unaware of, which
is that these medicines kind of got their start being
(03:00):
used for self managed abortion in Latin America, where abortion
is legal, abortion at least is in many places just
not available. UM and women it was this it was
initially an ulcer drug. Am I remembering that correct. Misa
Prostel was originally registered for ulcers. And it was women
in Brazil who noticed that right on the pill container
(03:21):
it said do not use if you're pregnant, could cause
undine contractions. And as in every country in the world
for generations, if people don't want to be pregnant, they
try to figure out a way to add that pregnancy,
regardless of the law. So women started experimenting with taking
misa prostal. Ultimately, the World Health Organization has studied these
(03:42):
pills and come up with the most recommended protocols, which
people can find on our website abortion pill info dot
org or in many many places in the Internet if
they google the words and Lisa Prostal and abortion and
you're you're going to sation doesn't provide the pills, but
you do provide people information on how right the idea
(04:05):
of sunds because there are restriction there are some legal
risks in people in these pills on there on, even
before this draccone in law in Texas which tries to
criminalize everybody, um, but it is legal to share information
that's published in scientific journals and by the world's health organization.
So on the website abortion pill infot dot org are
(04:26):
the protocols for how to use mice acrosto alone or
in combination with metho christo, because it is a little
more effective with when combined with methochristo, but the metho
cristo is harder to get to get. And I you know,
people I think are often frightened about just the idea
of self managed abortion, in part because when people talk
(04:46):
about the bad old days before Roe v. Wade, they're
talking about something that I think people would think about
when they hear self managed abortion, if they're not aware
of kind of what it actually is. But one of
the points you make that I think is so valid
is that just a in its own like if you
do nothing about pregnancies self terminate on their own, and
(05:07):
this is what the pills are doing. It's nothing different
than what happens if you just kind of have an
embryo stop. Exactly. The pills caused the unse to contract
and push out whatever is in there. Um. I think
it's I think you raise a really important issue because
there's two things. One is these abortion pills have been
so tightly regulated and controlled by our medical um institutions
(05:31):
that people aren't as familiar with them as they could
and should be. I mean, these pills are so safe
that they could be in people's medicine cabinets. Um. But
in this country, sexuality is really restricted. We should have
over the counter birth control pills that biled. So the
first thing is I think is just to demystify these
pills and to say that they're safe and effective. But
the other is the stigma around abortion. Yeah, the anti
(05:54):
abortion people have worked really hard to make people ashamed
about their sexuality and ashamed about a pregnancy that they
didn't want, as if people can do it all by
themselves without somebody else being involved. And so this burden
on women is they don't even they're so shamed that
they have a lot of fear and stigma around, um,
trying to get an abortion, even outside of Texas. But
(06:17):
then you compound it with this fear that has been
raised by the anti abortion people, all this misinformation, Oh
these pills aren't saying, oh they could cause breast cancer,
Oh they can impair future fertility, all of which has
been debunked and is not true. But as we all know,
misinformation has a long shelf life, a longer shelf life
(06:38):
than the truth in a lot of cases. Exactly, I
wanna talk a little bit about just kind of the
facts about how this stuff functions. So particularly from IM
we have a lot of listeners in Texas. I'm sure
a decent number of the people listening right now are
are very rightfully concerned. The present law essentially criminalizes uh
(07:01):
medical abortion after six weeks um at what's how how
late through do these pills work? Um? And then the
second question I have is obviously a lot of women
who get pregnant, don't realize they're pregnant for until after
six weeks. It can take a while. So what options.
I know you have some options to recommend for tracking
uh that that that that are helpful as well an app.
(07:24):
So the first thing I just want to say is UM,
a lot of people don't know how to calculate the
number of days of pregnancy, and they hear this term
l MP last menstrual period. Basically, people can count from
the first day of their last menstruation to figure out
how pregnant they are. UM. We do have an app
that I want to recommend called Yuki e u k
I comes from the word eucalyptus, which is a menstrual tracker,
(07:48):
but also has information about how to use contraception, how
to use abortion pills. It is private and secure. UH.
The the information is not available to anybody. It was
not commercially developed, was developed by grants. So even we
don't know other than how many people download it, we
don't know how people are using it. So I really
I think it's really important that people understand how their
(08:10):
bodies work, understand how to figure out how pregnant they are,
and then understand how to use these pills. You asked
a really important question, which is how late can these
pills be used? Um, The w h O has studied
the use of these pills through twelve weeks, and there
is a set of protocols for how to use them
for twelve weeks and basically, with mice across alone, a
(08:31):
person would need twelve tablets two hundred micrograms each. They
would put four pills under their tongue, let them dissolve
thirty minutes and then swallow, wait three hours to do
it again, four pills under the tongue thirty minutes and
then wait three hours and then use the last four pills. However,
after twelve weeks, the pills can also be used to
(08:53):
end up pregnancy. Mice acrostal can be used for labor induction.
Counter Intuitively, however, the large longer the pregnancy, the less
mice across them is needed, and a person doesn't want
to take too much. Exactly, you and I probably think, oh,
I have a headache, I'll take to ask for it.
Oh it didn't go away, I'll take two. More counter intuitively,
as the uterus stretches with pregnancy, it's more sensitive to
(09:15):
mines approsto and actually can be dangerous to use as
much as one would use in the first twelve weeks.
Anybody who wants to learn more can either go on
the website abortion pill info dot org or use that
website and contact skilled counselors from Women Help Women who
are based overseas, who answer over twelve thousand emails a
(09:36):
month about how to use these pills, and they will
counsel people regardless of the number they need to know,
how many weeks pregnancies they will they will adapt the
information to that situation. But most people in this country
who have gone to clinics for abortion do it in
the first nine or ten weeks, and these pills are
extremely safe and effective to use with these w H
(09:58):
protocols up to twelve weeks. So while you're correct that
most people don't know they're pregnant at six weeks, they
at the time they're they've missed a period usually and
they're they've taken a pregnancy test, and the urin pregnancy
test that people buy in the dollar store over the
pharmacy are pretty are pretty accurate. Yeah, you brought up something,
(10:29):
which is that who have these people who can help
provide advice and their overseas, and you you kind of
specify that every time I see you, I hear you
talk about it, and you also specify the degree of
security um which you which you put on these conversations UM.
And it's a degree that I think is uncommon for
(10:50):
what should be a pretty basic medical procedure. And it's
obviously because of there's potential consequences here. I'm interested in
kind of what are some of the present legal consequence
is and what are some of your worries when you
adopt these very stringent security measures for people who come
to you. So let's leave Texas aside. Prior to the
Texas law, approximately twenty four people in the United States
(11:13):
have been prosecuted for using abortion pills without a clinician involved,
in other words, for self managing their abortion UM. It's
important to say most of the people who were prosecuted
were not ultimately convicted, but somewhere because many states criminalize
the use of these pills without a clinician involved. That
(11:34):
being said, thousands and thousands of thousands of people are
obtaining mys acostal or mio cristal plus myz acrostal in
the United States. We have some websites where that actually
share the number of pills that they're sending into the US.
And we also know about my acrostal sales um going
way up in the countries where it is available of
(11:56):
an encounter, so there's no doubt. And also people have
shared their stories, so there that twenty four is a
tiny percentage of all the people who have been who
have used these pills. However, these pills are safe and
effective and nobody should have legal risk in using them. Therefore,
when we set up SASS, which is self managed abortion,
(12:16):
safe and supported and it's a project of this international
organization Women Help Women, we were very aware that in
the U s there's a lot of surveillance of people's bodies,
there's a lot of potential to pack into people's emails.
So we set up a very secure system where people
can email our overseas counselors UM on a very secure
(12:38):
server and get back a an answer that will disappear
within seven days, so there's no evidence in their phone
or electronic device that they ever sent this email. We
just thought, you know, it's an extra step. Um. Most
people probably aren't even aware they're going through a secure site,
but we want to make sure that nobody who who
contacts us can ever be prosecuted. Yeah, and it's I mean,
(13:02):
it seems like you're were especially given the nature of
the Texas law, you're worried about vigilantes as much as anything,
not necessarily even the state, but but you know, the
kind of people who show up outside of planned parenthoods
with guns. The good thing about an international organization running
this is none of the people answering the email are
in the US. Yeah, pretty difficult for these Texas vigilantes
(13:22):
or frankly anybody else to file a lawsuit. First of all,
it's all anonymized. They don't we don't. Women Help Them
doesn't advertise who our staff are, and none, none of
them are in this country. I mean, that's very smart.
When did when was it set up this way? Like
how long ago were you kind of thinking about the direction,
because it seems like you you had a pretty blunt
(13:45):
understanding of where things were headed. So Women Help Women
was founded in and we work in eighty two countries.
We work in countries like the Philippines where any kind
of drug deal dealer has been called. Yeah, work in
Poland where abortion is not legal. In anywhere in the country.
We work in many places in Latin America where abortion
(14:08):
is highly criminalized, so we had security set up from
the beginning. It was actually shortly after the election of
h I'll call him Orange forty five because I've sworn
that this our ex president's name, will never cross my lips.
Uh from Poland said, you know, we used to have
legal abortion and we lost it, and you're gonna lose
it too. People in the US better, you know, we
(14:31):
should do something for people in the United States, and
that's why so SAS was founded shortly after the inauguration
of the last president and has been in place ever since.
A lot of our work is not just the website
and answering, it's really raising the awareness of our colleagues.
We also before COVID went into communities. Now we do
(14:51):
it for via Zoo. We actually do three hour trainings
to teach people how to use these medicines and how
to teach others' we uh, you know, we have manual Spanish.
We have people doing these trainings all over the US
UM and have reached thousands of people directly with this
information UM sort of prophylactically with the belief that it
(15:14):
shouldn't be when a person is pregnant that they understand
how these pills work. This is basic information that gotten
in high school. It's like knowing how to put on
a tourniquet or something. It should be part of your
first stage. How do you when to put on a
band aid and when to take an aspirint? You know,
how do you treat a cold? So the knowledge about
(15:35):
these pills, we've worked very hard to make it very accessible.
We actually have load we you know, we've done these
trainings and countries where there's not a lot of literacy,
so with graphics, we have videos. We have lots of
ways to teach. Many aren't appropriate for the u S
where there's more literacy but sometimes less understanding about how
bodies work. So um. So our goal has been to
(15:57):
you know, we also go to professional conferences and so
channels and try to raise awareness within the reproductive rights
and reproductive justice movement about the importance of self managed
abortion as an intol of empowerment and breaking stigma. Not
as hey, if you can't get to a clinic, tribes,
but why why is this option not available to me?
In a state of Massachusetts where I live where there's
(16:19):
plenty of clinics, But why can't I just walk down
to the to the Walgreens and get these pills if
a doctor tells me it's okay, or without a doctor, Yeah,
they're so safe. So we've really, we really advocate for
self managed abortion as a viable option. UM. It should
be viable regardless of the law. Obviously for many people
it's the only option in places like Texas. UM. But
(16:44):
it's as good, it's a better. Some people don't want
to go see a clinician. Yeah, they don't want to
go through a bunch of protesters. They would just like
to get a package in the mail with their medicines. Yeah,
I mean it's and that's I mean, there's there's both
the the tool of an immediate need that there's there's
desperate people who need access to this, but it's also
in a broader sense, like building power within individuals and
(17:07):
within communities to manage their own reproductive healthcare, which I
think is really important exactly. And there are people who
could get to a clinic and have them needs to
go to a clinic, who are opting not to go
to a clinic. And two because they feel confident in
their ability to take these pills as directed to manage it.
And I just want to say, we started this conversation
(17:27):
with talking about of all praises end in a miscarriage.
Most people have a miscarriage don't get medical care. Yeah,
they can manage the bleeding and they know when it's
over and they know that fine, which I think is
an important point because I know people who have had
very difficult miscarriages, but that's not most of the most
of them are are mild enough that yeah, like you said,
(17:49):
you don't need medical care. Well, I just so, I
just want to be clear. You know, using the abortion
pills does cause cramping and bleeding, but it is not
so far out of most people with the uterus is
experience to have cramping and bleeding every month. This is
heavier cramping, heavier bleeding, but we we know how to
(18:10):
deal with this. Another point you make that I think
is really important is that you know, with any medication,
there's a chance it will be used wrong or it'll
have an expected effect. If you have to if you
(18:31):
take this stuff and you have to go to the doctor,
you don't need to tell the doctor. This is what
I've taken you you like, could you talk to that
about a little bit how someone would if they needed
to go to the doctor as a result of an
interaction or something, what they would would be best to say.
There are two kinds of complications that can happen in
very very rare cases. The person can bleed too much,
(18:51):
have a hemorrhage, and they absolutely mean medical care. The
chance of a hemorrhage with these pills is exactly the
same as the has a chance of the hemorrhage with
a natural miscare. So it happens. Doctors in every e
r know how to treat it. The other complication that
can happen is in infection. You know, there's some retained
tissue and the bleeding continues and they need to get antibiotics.
(19:13):
So what's really interesting about these pills is they move
through the body relatively quickly and there is no test
of blood or urine for them as long as the person,
especially if the person followed the directions and use them
under the tongue or in the cheeks, they've gone through
the stomach, they're gone. Yeah. In some directions say to
use the MISA prostal vaginally. The problem with that is
(19:37):
the inert substances, and the pills could stay in the
vagina for up to three days, and then there's evidence,
right because the doctor could see the crumbs if they
do a pelvic exam. But as long as the person
used the pills, either used the mice aprostal one swallows
the mephopristom, as long as they use it in the
and that's absorbed through the mouth, there are no tests.
So the person can say I'm bleeding and I don't
(19:59):
know why, which, by the way, many people with a
miscaracter now they were pregnant. Happens all the time, or
they could say I was pregnant and I think I'm
having a miscarriage. Yeah, we are really trying to work
with some professional groups to increase awareness that people shouldn't
be vigilanties, healthcare providers should not be vigilanties. But the
(20:20):
only way a person is going to get in trouble
is if they say they use the medicines. Even if
the doctor says, did you use the medicines, there is
no reason to say it. The treatment is exactly the
same as for a natural miscarriage. I wanted to ask
kind of how listeners, particularly listeners who you know may
not personally need this medicine but may want to support
(20:44):
what you're doing, or may need the medicine and still
want to support what you're doing. Are there ways in
which people can either financially or otherwise help support y'all?
Absolutely again. Abortion pill info dot Org is our website.
There's a whole section of what people can do. They
can they can learn about these pills and tell other people.
They can get stickers to let people know they exist.
Because remember, most people don't know there are abortion pills,
(21:06):
so they don't even know how to look on the
internet for this thing, you know, so sharing information is
really important. There's also a donation button there, but the
biggest thing that people can do in this moment, apart
from donating, is to educate themselves. They can either sign
up to take one of our trainings and become a
(21:27):
We call them trainers, but it's really information sharing. You know,
you and I have just talked about these pills. You
understand them more than you did half an hour ago.
Training a little too formal of a term for what
we do, but afterwards people will understand these pills very
well and be able to support others who either want
to know about them or are using them. And the
(21:47):
last thing I'd kind of like to ask you, if
you don't mind sharing, is how did you get into
this personally? Like what brought you into this line of
good question. So I've been doing abortion access work since
the eighties. UM. I was involved in the big demonstrations
in front of the clinics, etcetera. But I've also spent
(22:08):
a lot of time in Mexico where these pills are
over the counter and no, And it wasn't until and
I'm a little embarrassed to say this, but it wasn't
until about fifteen years ago that it's suddenly occurred to me,
Wait a second, I wonder why people in the US
aren't doing what what people in Mexico are doing. I'm just,
you know, it just it's like I was crossing the border,
(22:28):
but the idea hadn't crossed. And I started working with
another international organization of Women on Waves that was supplying
these pills all over the world, and I learned more
about them, and I eventually gave up my other day
job UM and started doing this work more directly over
the last ten years. Awesome, UM, Well, Susan, I think
(22:52):
that's everything I had to ask. Was there anything else
you wanted to make sure to get out today? No,
I just want to be really clear that well, this
is a human right and that they're people should have
the option of going to a clinic. And the closing
of the what you know, this is going to result
in clinics in Texas being down essentially nobody who's you know,
and they can't keep their doors open with a few
(23:14):
people who happen to get in before six weeks. And
I think we have to do everything possible to support
there being access to clinicians, that this is an option
that we all need to learn more about and to
think about why why is this so controlled? If this
was a medicine, like it's more controlled than than opiates.
It's certainly more controlled than beyond and it's crazy and
(23:39):
it's a misogynistic that these pills are not in our hands. So,
um yeah, I would encourage your listeners to get on
the website if they want more information there is you know,
they can easily email through the website and learn whatever
they want. Um. But it's all of our responsibility to
learn this and to help get this information out absolutely,
(24:02):
Susan Yano, thank you so much for talking with us
today and thank you all for listening. This has been
It Could Happen Here and we'll be back tomorrow UM
with another episode. Thank you so much, season you're very well.
It Could Happen Here as a production of cool Zone Media.
(24:23):
For more podcasts from cool Zone Media, visit our website
cool zone Media dot com, or check us out on
the I Heart Radio app, Apple Podcasts, or wherever you
listen to podcasts. You can find sources for It Could
Happen Here, updated monthly at cool zone Media dot com
slash sources. Thanks for listening.
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James Stout
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